Individual provider Active NPI

Devin Blake Griffin, LMSW

  • Professional Counselor
  • Bronx, NY
National Provider Identifier
1417410994
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
101615 Issued in NY
Practice address
1990 Westchester Ave Ste B
Bronx, NY 10462-4553
Phone
(347) 361-1276
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 101615 NY Primary

Addresses

Primary practice location

1990 Westchester Ave Ste B
Bronx, NY 10462-4553

Mailing address

76 Thayer St Apt 3K
New York, NY 10040-1170

Other practice location 1

2976 Northern Blvd
Long Island City, NY 11101
Phone (347) 361-1276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114002174 SC Practitioner - Clinical Social Worker 7719355205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wildflower Center for CounselingGroup PAC ID 1254710486, 5 clinicians

Practice addresses (Care Compare)

774 S Shelmore Blvd
Suite 108
Mount Pleasant, SC 29464-7626
Phone (843) 936-2566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101615NYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wildflower Center for Counseling CurrentSince Oct 1, 2022 Accepting new patients

Locations

774 S Shelmore Blvd
Ste 108
Mt Pleasant, SC 29464
Phone (843) 936-2566

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1417410994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 THAYER ST APT 3K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 WESTCHESTER AVE STE B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104624553",
            "telephone_number": "347-361-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2976 Northern Blvd",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "11101",
            "country_code": "US",
            "telephone_number": "347-361-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "DEVIN",
        "middle_name": "BLAKE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "101615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.